Neuropsychology and Cognition Poster Presentation

P0793 - Clinical course impacts on the association between general cognition and mentalizing deficits in MS (ID 1614)

  • M. Pardini
  • M. Pardini
  • E. Colombo
  • R. Meli
  • C. Lapucci
  • N. Bruschi
  • G. Boffa
  • M. Cellerino
  • E. Sbragia
  • A. Uccelli
  • M. Inglese
Presentation Number
Presentation Topic
Neuropsychology and Cognition



Theory of Mind (ToM, i.e the ability to decode emotional states) is a cognitive function that plays a key role in social functioning. While ToM deficits have been found to be frequent in subjects with MS, ToM is not routinely assessed in formal neuropsychological assessments in this population. The lack of inclusion of ToM assessment in routine neuropsychological evaluation of MS patients, stems from different causes including a partial characterization of the association between general cognition and ToM in the different phases of the disease.


To evaluate the interaction between clinical course (relapsing remitting MS (RRMS) vs progressive MS (PMS)), ToM deficits and general cognition. More in detail we aim to assess if the role played by general cognitive functioning on ToM is different in PMS rather than in RRMS


120 MS patients (age: 44.9±11.6 years, median EDSS 2.5 range 1-6; 75 subjects with RRMS and 45 with PMS) were assessed with the Symbol Digit Modalities Test (SDMT) to evaluate general cognition and the Reading the Mind in the Eyes Test (RMET) to evaluate ToM. The RMET, developed by Baron-Cohen and colleagues in 2001 is a standardized test that consists of 36 black and white picture of the eye region; the subject has to recognize the emotional state represented in the picture and choose one among four given words that depict an emotion.


Comparing RRMS and PMS patients, there was a significant difference in SDMT (55.3±12.0 vs 40.2±11.0, p=0.001) and in total RMET (27.0±4.0 vs 22.9±3.0 p=0.001) scores. There was a significant correlation between SDMT and ToM in the whole sample (p<0.001, r=0.45) and in the RRMS group (p=0.001, r=0.48, but not in PMS (p=0.83) group.


The association between SDMT and RMET is modulated by clinical course in MS. This observation suggests that a bigger role is played by general cognition on RMET in RRMS rather than in PMS possibly due to the presence of more diffuse damage in PMS. Our data suggest that these two metrics change differently over the disease course and thus provide complementary information in the study of cognitive deficits in MS.